A comparison of placement techniques and complications of externalized catheters and implantable port use in children with cancer.
The complications associated with the placement and use of Hickman catheters (n = 120), Broviac catheters (n = 146), and implantable ports (n = 93) in children with cancer were analyzed. Percutaneously placed central venous access devices (CVADs) tended to fail less often (P = .86) and to develop infections less often (P = .056) than surgically placed CVADs. The difference in complications with percutaneous versus surgically placed CVADs requires confirmation in a randomized trial to assure they are not a result of differences in patient characteristics. When all catheter failures (removal due to infection, obstruction, or dislodgement) were considered, ports had a significantly longer failure-free duration of use than externalized Hickman and Broviac catheters (P = .0009). Ports also remained infection-free longer than externalized catheters (P = .0014). The greatest risk of infection occurs in the first 100 days of use, particularly for ports. This study demonstrates that for long-term use (greater than 100 days) ports are superior to externalized catheters in children with cancer.
Mirro
J
J
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101.
Rao
B N
BN
Kumar
M
M
Rafferty
M
M
Hancock
M
M
Austin
B A
BA
Fairclough
D
D
Lobe
T E
TE
D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002493:Central Nervous System Diseases / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007938:Leukemia / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D009369:Neoplasms / Q000188:drug therapy*; D013997:Time Factors